An estimated half a billion individuals worldwide carry the herpes simplex virus, type 2 (HSV-2).
This strain of herpes virus is most commonly associated with genital herpes, whereas the herpes simplex virus, type 1 (HSV-1) is most commonly associated with oral herpes, which show up as “cold sores” around the mouth. However, both strains of HSV are capable of causing herpes outbreaks either orally or genitally. Typically, genital herpes is more common in densely urban areas like New York City, and in developing countries, like those in Sub-Saharan Africa. People with genital herpes may remain symptom-free, but still occasionally “shed” the virus, which can then be unknowingly transmitted to a sexual partner.
Two Types of Herpes and How They’re Transmitted
Once a person is infected with either strain of HSV, the virus typically produces an initial outbreak (though many infected people never experience this), and then goes dormant in the nervous system. Once that happens, the virus can be reactivated at any time, causing further outbreaks. It is possible for a person infected with herpes to develop herpes infections in other systems of the body, such as the brain or eye.
Either type of herpes virus can be transmitted through unprotected sexual activity between someone experiencing an outbreak and an uninfected person. The virus can also be transmitted through contact such as kissing, or sharing eating utensils or personal grooming items (like towels or razors) between someone with an outbreak and an uninfected person. It can also be transmitted from a mother to her baby during childbirth, and this can lead to serious illness in the newborn.
According to leading immunology researcher William Jacobs, Jr., PhD, “Developing a herpes vaccine is one of the holy grails of infectious disease research.” Not only could a vaccine prevent the misery of repeated herpes outbreaks, it could play a major role in curbing transmission of HIV, which is more likely to be both acquired and transmitted by those with HSV-2.
So far, neither strain of herpes can be cured, though outbreaks can be treated so that they’re milder and don’t last as long. Generally the initial outbreak of herpes (oral or genital, whether caused by HSV-1 or HSV-2) is the most severe. Some people never have another outbreak. Others experience recurring outbreaks, and usually each subsequent outbreak is less severe. However, outbreaks can be not only painful, but put serious limits on a person’s intimate contact, which can be emotionally unsettling.
Swedish Researchers Target Genital Herpes Infection
Swedish researchers, led by Dr. Josefine Persson of Sahlgrenska Academy in Göteborg, have conducted experiments in mice testing two delivery options for establishing immunity to genital herpes: injected locally into the skin, or inhaled through the nose. They found that both methods conferred immunity to acute genital herpes infection, and that the nasally delivered vaccine offered partial immunity to latent infections. This is a big deal because it is the repeated outbreaks that can be so painful and limiting to people with herpes, outbreaks that happen because the virus goes into the nervous system before going latent.
Dr. Persson tested two different kinds of “adjuvants,” which are molecules that activate the immune system or improve uptake of vaccines that are based on part of a bacteria or virus. Both adjuvants worked well, and have already been tested in human trials.
Researchers in New York Discover Novel Vaccine Design
Immunology researcher Jacobs, mentioned above, along with Betsy Herold, MD of the Children’s Hospital at Montefiore and Einstein, have found a novel way of approaching vaccination against herpes, and it involves using a virus that lacks a protein on its outer coat called gD-2. The conventional wisdom used to be that an effective herpes vaccine had to stimulate neutralizing antibodies against gD-2.
However, Jacobs and Herold hypothesized that gD-2 was actually a sort of “Trojan horse” that actually hid other antigens – ones that a vaccine for HSV should target. Apparently, attempts to develop vaccines previously have been stimulating production of the wrong antibodies. But now, using mutant viruses that lack gD-2, vaccines can target these other, previously hidden antibodies. The vaccine Jacobs and Herold developed was found to be effective against both HSV-1 and HSV-2 in mice.
If the vaccine works in humans the way it works in mice, administering the vaccine early in life could do away with herpes latency completely, which would be a major public health breakthrough. Additionally, this knowledge could lead to new research into vaccines for major diseases like HIV and tuberculosis.
Genocea Biosciences Developing Immunotherapy for People With Herpes
For people who already have HSV-2, a biotech company called Genocea is developing a new immunotherapy that could control outbreaks. They’ve developed an immunotherapy “vaccine” that works to target a T-cell response against HSV-2, reducing viral activity, which is measured by the rate of viral shedding and the number of genital lesions.
A recent study of 310 people infected with herpes found that the vaccine, called GEN-003, caused a statistically significant improvement in the viral shedding rate compared to baseline viral shedding rates and compared to placebo. The company was able to replicate these results and determine the best dose of the protein and corresponding matrix substance that targets the T-cell response. Viral shedding was reduced by 55% after 28 days compared to baseline measures. Researchers also plan studies on whether the vaccine can reduce transmission rates for HSV-2 as well.
Today’s Options for Treating Herpes
People who have repeated outbreaks of herpes (HSV-1 or HSV-2) have treatment options today that can significantly shorten the duration and curb the severity of outbreaks when the treatments are started at the first sign of an outbreak. The drugs Denavir, Acyclovir, Famvir, and Valtrex work by preventing reproduction of infected cells. While they don’t “cure” herpes or prevent it from coming back, they can significantly improve quality of life for people who have repeated outbreaks and help these people avoid transmitting the virus to others.
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